Applied Epidemiology Competencies

A E Cs

Competencies for Applied Epidemiologists in Governmental Public Health Agencies (AECs) Partner organizations participating in the development of these competencies: CDC/CSTE Competencies for Applied Epidemiologists in Governmental Public Health Agencies

I. Skill Domain—Assessment and Analysis

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert A. Recognize public health problems A. Identify public health problems A. Ensure identification of public A. Validate identification of public pertinent to the population pertinent to the population health problems pertinent to the health problems pertinent to the population population

1. Recognize the existence of a public 1. Use critical thinking to determine 1. Ensure that critical thinking is used to 1. Synthesize key findings from the health problem whether a public health problem exists determine whether a public health critical thinking process to determine problem exists whether a public health problem exists

a. List relevant data and information a. Identify relevant data and a. Validate the relevance of data and a. Use relevant data and information sources within and outside the public information sources within and information sources within and sources within and outside the public health system outside the public health system outside the public health system health system b. Seek assistance synthesizing existing b. Synthesize existing data and b. Verify the accuracy of expected and b. Synthesize existing data and data and information into a information into a determination of observed numbers of cases or information into a determination of determination of expected and expected and observed numbers of outcomes in a population expected and observed numbers of observed numbers of cases or cases or outcomes in a population c. Ensure the accuracy of determined cases or outcomes in a population outcomes in a population c. Determine threshold values (e.g., threshold values (e.g., baseline c. Validate the calculated threshold c. Seek assistance in determining baseline disease burden, prevalence disease burden, prevalence of risk values (e.g., baseline disease burden, threshold values (e.g., baseline of risk behaviors) for public health behaviors) for public health action prevalence of risk behaviors) for disease burden, prevalence of risk action d. Verify the completeness and public health action behaviors) for public health action d. Conduct a thorough search of the accuracy of searches of literature and d. Synthesize results of searches of the d. N/A scientific literature and public health public health databases scientific literature and public health e. N/A databases using search engines and e. Verify population-based health risks databases f. N/A methods relevant to specific f. Decide whether to obtain expertise e. Verify population-based health risks problems outside the agency to assist in f. Determine whether additional e. Quantify population-based health decision-making outside expertise is needed to assist risks in decision-making f. N/A

2. N/A 2. Articulate the need for further 2. Decide whether to conduct further 2. Evaluate need for further investigation investigation or other public health investigation or other public health or other public health action on the action on the basis of results of action on the basis of results of basis of results of literature review and literature review and assessment of literature review and assessment of assessment of current data current data current data

3. Collaborate with others inside and 3. Collaborate with others inside and 3. Lead collaborations with others inside 3. Lead collaborations with others inside outside the agency to identify the outside the agency to identify the and outside the agency to identify the and outside the agency to identify the problem problem and form recommendations problem and form recommendations problem and form recommendations

Centers for Disease Control and Prevention / Council of State and Territorial Epidemiologists February 2008 version 1.2 1 CDC/CSTE Competencies for Applied Epidemiologists in Governmental Public Health Agencies

I. Skill Domain—Assessment and Analysis

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert B. Conduct surveillance activities B. Conduct surveillance activities B. Oversee surveillance activities B. Organize surveillance

1. N/A 1. Design surveillance for the particular 1. Approve surveillance for the particular 1. Evaluate validity of conducting public health issue under consideration public health issue under consideration surveillance for the particular public health issue under consideration

a. N/A a. Identify types of surveillance a. Examine potential surveillance a. Examine types of surveillance b. N/A methods for specific public health methods for specific public health methods for specific public health c. N/A problems problems problems d. N/A b. Identify information system(s) to b. Approve information system(s) to b. Recommend information system(s) e. N/A support surveillance systems support surveillance systems to support surveillance systems c. Recommend types of surveillance c. Decide on types of surveillance c. Determine type of surveillance systems for specific public health systems for specific public health systems for specific public health problems problems problems d. N/A d. Review anticipated cost/benefit of d. N/A e. Identify additional burden to public initiating a new surveillance system e. Evaluate additional burden to public health system and reporting entity e. Decide whether to impose the health system and reporting entity anticipated to result from the additional burden to public health anticipated to result from the proposed surveillance system system and reporting entity that is proposed surveillance system anticipated to result from the proposed surveillance system

2. Identify surveillance data needs 2. Identify surveillance data needs 2. Decide on surveillance data needs 2. Evaluate surveillance data needs

a. Create case definition(s) based on a. Create case definition(s) based on a. Verify case definition(s) based on a. Evaluate case definition(s) based on person, place, and time person, place, and time person, place, and time person, place, and time b. N/A b. Describe sources, quality, and b. Decide on sources of surveillance b. Evaluate sources, quality, and c. N/A limitations of surveillance data data limitations of surveillance data d. N/A c. Define the data elements to be c. N/A c. Assess the adequacy of the data e. N/A collected or reported d. Decide on mechanisms to transfer elements to be collected or reported f. N/A d. Identify mechanisms to transfer data data from source to public health d. Assess mechanisms to transfer data g. Recognize potential uses of data to from source to public health agency agency from source to public health agency inform surveillance system e. Define timeliness required for data e. Decide on acceptable timeliness for e. Evaluate timeliness requirements for h. N/A collection data collection and frequency for data collection f. Determine frequency of reporting reporting f. Assess frequency of reporting g. Describe potential uses of data to f. N/A g. Create surveillance system design on inform surveillance system design g. Decide on surveillance system the basis of potential uses of data h. Define the functional requirements design h. Assess the functional requirements of the supporting information system h. Approve the functional requirements of the information system of the supporting information system

Centers for Disease Control and Prevention / Council of State and Territorial Epidemiologists February 2008 version 1.2 2 CDC/CSTE Competencies for Applied Epidemiologists in Governmental Public Health Agencies

I. Skill Domain—Assessment and Analysis

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert 3. Implement new or revise existing 3. Implement new or revise existing 3. Supervise or manage implementation of 3. Implement new or revise existing surveillance systems surveillance systems new or revision of existing surveillance surveillance systems systems

a. Define objectives and uses of a. Define objectives and uses of a. Approve objectives and uses of a. Develop guidelines for objectives surveillance system surveillance system surveillance system and uses of surveillance systems b. Test data collection, data storage, b. Test data collection, data storage, b. Validate data collection, data b. Validate data collection, data and analytical methods as directed and analytical methods storage, and analytical methods storage, and analytical methods c. Assist in creating working c. Create working surveillance system c. N/A c. Create working surveillance system surveillance system d. Verify that data collection occurs d. Verify that data collection occurs d. Assess performance of data d. Collect data for verification of the according to the defined surveillance according to the defined surveillance collection systems against the defined surveillance system system parameters (e.g., timeliness, system parameters (e.g., timeliness, defined surveillance system parameters (e.g., timeliness, frequency) frequency) parameters (e.g., timeliness, frequency) e. Ensure correct classification of cases e. N/A frequency) e. Classify potential cases according to according to the case definition f. N/A e. N/A whether they meet the case definition f. Interview people with illness to g. Ensure that data quality is monitored f. N/A f. Interview people with illness to solicit necessary information h. Ensure good working relationships g. Monitor data quality solicit necessary information g. Monitor data quality with reporting entities h. Create good working relationships g. Assist in monitoring data quality h. Create good working relationships i. Ensure provision of feedback to with reporting entities h. Maintain good working relationships with reporting entities reporting entities and other i. Synthesize information about with reporting entities i. Provide feedback to reporting organizations or individuals who surveillance system for i. Provide feedback to reporting entities and other organizations or need to know about the data or communicating to reporting entities entities and other organizations or individuals who need to know about system and other organizations or individuals who need to know about the data or system individuals who need to know about the data or system the data or system

Centers for Disease Control and Prevention / Council of State and Territorial Epidemiologists February 2008 version 1.2 3 CDC/CSTE Competencies for Applied Epidemiologists in Governmental Public Health Agencies

I. Skill Domain—Assessment and Analysis

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert 4. Report key findings from the 4. Identify key findings from the 4. Synthesize key findings from the 4. Synthesize key findings from the surveillance system surveillance system surveillance system and other pertinent surveillance system and other pertinent information for use by decision-makers information for use by decision-makers

a. Provide system’s results to senior a. Examine system’s results in the a. Interpret system’s results in the a. Interpret system’s results in the epidemiologists context of current scientific context of current scientific context of current scientific b. Recognize implications to public knowledge knowledge and other available knowledge health programs b. Identify implications to public health information b. Examine any implications to public c. Assist in developing conclusions programs b. Examine any implications to public health programs from the surveillance data c. Develop conclusions from the health programs c. Determine relative priority of each d. Communicate results to senior staff surveillance data c. Determine relative priority of each conclusion from the surveillance d. Communicate results to agency conclusion from the surveillance data, before making managers and to reporters of data, before making recommendations to decision-makers surveillance data (see recommendations to decision-makers d. Communicate synthesized Communication competencies) d. Communicate synthesized information to decision-makers and information to decision-makers and the public the public

5. Support evaluation of surveillance 5. Conduct evaluation of surveillance 5. Ensure evaluation of surveillance 5. Design and conduct evaluation of systems systems systems surveillance systems

a. Collect data necessary for evaluation a. Evaluate surveillance systems using a. Ensure evaluation of surveillance a. Evaluate surveillance systems using of surveillance systems using national guidance and methods* systems using national guidance and national guidance and methods* national guidance and methods* b. Propose recommendations for methods* b. Develop and/or review b. Assist in preparing recommendations modifications to surveillance b. Appraise recommendations for recommendations for modifications for modifications to surveillance systems on the basis of evaluation modifications to surveillance to surveillance systems on the basis systems on the basis of evaluation c. N/A systems on the basis of evaluation of evaluation c. N/A d. Implement changes to surveillance c. Decide whether to modify c. Decide whether to modify d. Assist in implementing changes to system on the basis of results of surveillance systems on the basis of surveillance systems on the basis of surveillance system on the basis of evaluation recommendations recommendations results of evaluation d. Ensure that changes to surveillance d. Ensure that changes to surveillance system are implemented on the basis system are implemented on the basis of results of evaluation of results of evaluation * See Centers for Disease Control and Prevention (US). Updated guidelines for evaluating public health surveillance systems; recommendations from the Guidelines Working Group. MMWR Recomm Rep 2001;50(RR-13):1–35.

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I. Skill Domain—Assessment and Analysis

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert C. Identify acute and chronic C. Investigate acute and chronic C. Ensure investigation of acute and C. Design investigation of acute and conditions or other adverse outcomes conditions or other adverse outcomes chronic conditions or other adverse chronic conditions or other adverse in the population in the population outcomes in the population outcomes in the population

1. Assist in conducting a community 1. Conduct a community health status 1. Oversee a community health status 1. Design a community health status health status assessment assessment assessment assessment

2. N/A 2. Recommend priorities of potential 2. Decide on priority of public health 2. Recommend priorities of potential public health problems to be addressed problems to be addressed public health problems to be addressed

3. Characterize investigative processes 3. Select investigative processes 3. Approve selection of investigative 3. Determine investigative processes processes

a. Recognize different principles of a. Apply principles of investigation for a. Determine whether to use a. Determine whether to use investigation for endemic/sporadic endemic/sporadic illness or disease investigative methods for investigative methods for illness or disease clusters vs. acute clusters vs. acute outbreaks endemic/sporadic illness or disease endemic/sporadic illness or disease outbreaks b. Describe the major epidemiologic clusters vs. acute outbreaks clusters vs. acute outbreaks b. List the major epidemiologic study study designs, including the b. Decide which epidemiologic study b. Integrate knowledge about designs, including the strengths and strengths and weaknesses of each design to use for the public health epidemiologic study designs into weaknesses of each problem to be investigated study design for the public health problem to be investigated

4. Create hypotheses 4. Create hypotheses 4. Verify hypotheses 4. Verify hypotheses

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I. Skill Domain—Assessment and Analysis

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert 5. Assist in design of investigation (e.g., 5. Assist in design of investigation (e.g., 5. Oversee design of investigations (e.g., 5. Design investigations (e.g., disease disease investigations, studies, or disease investigations, studies, or disease investigations, studies, or investigations, studies, or screening screening programs) screening programs) screening programs) programs)

a. Identify target population for a. Identify target population for a. Validate selection of target a. Identify target population for investigation investigation population for investigation investigation b. N/A b. Perform power calculations if b. Approve power calculations b. Evaluate results of power c. N/A necessary c. Approve inclusion of individuals or calculations d. Create case definition(s) c. Identify individuals or groups groups in the study c. Verify individuals or groups for e. N/A eligible to be in the study d. Approve case definition(s) inclusion in the study f. N/A d. Create case definition(s) e. Approve time frame for investigation d. Create case definition(s) g. N/A e. Identify time frame for investigation f. Approve investigation design that e. Verify time frame for investigation h. N/A f. Select investigation design under will be most effective under existing f. Justify investigation design under i. N/A existing constraints constraints existing constraints j. N/A g. Identify possible sources of bias g. N/A g. Evaluate possible sources of bias h. Identify methods to minimize h. Approve methods to minimize h. Identify methods to minimize potential sources of bias potential sources of bias potential sources of bias i. Identify potential confounders i. N/A i. Evaluate potential confounders j. Design strategies to minimize or j. Approve strategies to minimize or j. Design strategies to minimize or eliminate potential confounding eliminate potential confounding eliminate potential confounding

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I. Skill Domain—Assessment and Analysis

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert 6. Conduct investigation as directed 6. Use investigation techniques consistent 6. Ensure use of investigation techniques 6. Design investigation techniques with the public health problem consistent with the public health consistent with the public health problem problem

a. Respond in a time frame consistent a. Respond in a time frame consistent a. Ensure that response is in a time a. Respond in a time frame consistent with the public health problem being with the public health problem being frame consistent with the public with the public health problem being investigated investigated health problem being investigated investigated b. N/A b. Apply methods and measures that b. Ensure that methods and measures b. Recommend methods and measures c. Contact data sources are consistent with the particular are consistent with the particular that are consistent with the particular d. Use methods for finding cases or type of investigation type of investigation type of investigation other subjects suitable to the c. Identify sources of data for c. Approve data sources for c. Verify selection of data sources for investigation investigation investigation investigation e. Use data collection instruments that d. Identify methods to find cases and d. Approve methods to find cases and d. Verify selection of case finding have been constructed for the other subjects suitable to the other subjects methods investigation investigation e. Approve data collection instruments e. Evaluate data collection instruments f. Use identified sampling methods e. Design data collection instruments and supporting information systems and supporting information systems g. Support necessary coordination using new or existing information f. Approve sampling methods given the f. Evaluate sampling methods given the among all groups involved in systems context of the situation context of the situation investigation f. Identify sampling methods given the g. Ensure coordination among all g. Organize necessary coordination context of the situation groups involved in investigation among all groups involved in g. Organize necessary coordination investigation among all groups involved in investigation

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I. Skill Domain—Assessment and Analysis

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert D. Apply principles of good ethical/legal D. Apply principles of good ethical/legal D. Ensure study design and data D. Synthesize principles of good practice as they relate to study design practice as they relate to study design collection, dissemination, and use ethical/legal practice for application and data collection, dissemination, and data collection, dissemination, follow ethical/legal principles to study design and data collection, and use and use dissemination, and use

1. Follow ethics guidelines and principles 1. Follow ethics guidelines and principles 1. Examine ethics guidelines and 1. Integrate ethics guidelines and when planning studies; conducting when planning studies; conducting principles when planning studies; principles when planning studies; research; and collecting, disseminating, research; and collecting, disseminating, conducting research; and collecting, conducting research; and collecting, and using data and using data disseminating, and using data disseminating, and using data

a. Collect and use public health data, a. Collect and use public health data, a. Ensure that public health data, a. Collect and use public health data, including individual identifiers, only including individual identifiers, only including individual identifiers, are including individual identifiers, only with clearly identified justification with clearly identified justification collected and used only with clearly with clearly identified justification b. Balance respect for people and b. Balance respect for people and identified justification b. Balance respect for people and individual privacy with the risk of individual privacy with the risk of b. Balance respect for people and individual privacy with the risk of the threat to the community the threat to the community individual privacy with the risk of the threat to the community c. Apply public health code of ethics to c. Apply public health code of ethics to the threat to the community c. Apply public health code of ethics to collection, management, collection, management, c. Ensure that public health code of collection, management, dissemination, and use of data and dissemination, and use of data and ethics is applied to collection, dissemination, and use of data and information, including principles of information, including principles of management, dissemination, and use information, including principles of justice, timeliness, and transparency justice, timeliness, and transparency of data and information, including justice, timeliness, and transparency of purpose† of purpose† principles of justice, timeliness, and of purpose† transparency of purpose†

2. Apply relevant laws to data collection, 2. Apply relevant laws to data collection, 2. Communicate to staff legal 2. Design data collection, management, management, dissemination, and use of management, dissemination, and use of expectations, limitations, and and dissemination and use of data and data and information data and information implications of collection, management, information to comply with relevant dissemination, and use of data and laws information

3. N/A 3. Describe differences between public 3. Obtain decision on whether 3. Verify conclusions that have been health practice and public health investigation involves public health reached regarding distinction between research practice or public health research public health practice and public health research

4. Describe human subjects research 4. Describe human subjects research 4. Ensure legal and ethical conduct of 4. Ensure legal and ethical conduct of human subjects research human subjects research

5. Apply Institutional Review Board 5. Apply Institutional Review Board 5. Ensure application of necessary 5. Ensure application of Institutional processes as directed processes as necessary Institutional Review Board processes Review Board processes † Available at http://www.apha.org/NR/rdonlyres/1CED3CEA-287E-4185-9CBD-BD405FC60856/0/ethicsbrochure.pdf. Accessed on February 20, 2008.

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I. Skill Domain—Assessment and Analysis

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert 6. Bring potential conflicts of interest to 6. Manage conflicts of interest as 6. Ensure that conflicts of interest do not 6. Ensure that conflicts of interest do not attention of senior epidemiologists necessary interfere with research or investigations interfere with research or investigations

7. Apply knowledge of privacy laws to 7. Apply knowledge of privacy laws to 7. Ensure application of privacy laws to 7. Incorporate privacy laws into study protect confidentiality, including Health protect confidentiality, including Health protect confidentiality, including Health design to protect confidentiality, Insurance Portability and Insurance Portability and Insurance Portability and including Health Insurance Portability Accountability Act and applicable state Accountability Act and applicable state Accountability Act and applicable state and Accountability Act and applicable and local privacy laws and local privacy laws and local privacy laws state and local privacy laws

8. Know agency procedures for handling 8. Know agency procedures for handling 8. Know agency procedures for handling 8. Know agency procedures for handling Freedom of Information Act requests Freedom of Information Act requests Freedom of Information Act requests Freedom of Information Act requests

9. Bring potential violations of ethical 9. Apply ethical principles in preparing 9. Ensure application of ethical principles 9. Apply ethical principles in preparing principles in preparing and submitting and submitting publications in preparing and submitting and submitting publications publications to attention of senior publications epidemiologists

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I. Skill Domain—Assessment and Analysis

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert E. Organize data from surveillance, E. Manage data from surveillance, E. Ensure management of data from E. Manage data from surveillance, investigations, or other sources investigations, or other sources surveillance, investigations, or other investigations, or other sources sources

1. Assist in definition of database 1. Define database requirements, if 1. Approve database requirements 1. Define database requirements, if requirements, if indicated indicated indicated

a. N/A a. Design database with or ensure that a. N/A a. Design database with, or ensure that b. Adhere to national standards for the database design includes the b. Verify use of variables and coding in the database design includes, the coding and variables as directed necessary variables and data databases necessary variables and metadata (e.g., assigning numeric codes to text dictionary c. Verify data entry techniques to b. Verify choice of coding and response options for a variable) to b. Adhere to national standards for ensure accuracy and reliability variables (e.g., assigning numeric ensure accuracy and ease of analysis coding and variables (e.g., assigning d. N/A codes to text response options for a c. Use data entry techniques that ensure numeric codes to text response e. Verify that valid data cleaning has variable) to ensure and balance accuracy and reliability options for a variable) to ensure occurred accuracy and ease of analysis d. Conduct data entry validation accuracy and ease of analysis f. Communicate results of data error c. Evaluate accuracy and reliability of e. Perform data cleaning and error c. Design data entry techniques that correction to data providers data entry techniques correction ensure accuracy and reliability g. Ensure that database requirements or d. Approve data entry validation f. N/A d. Conduct data entry validation design support analysis using processes g. N/A e. Perform data cleaning and error geographic information e. Approve data cleaning and error correction correction processes f. Communicate results of data error f. Communicate results of data error correction to data providers correction to data providers g. Define the requirements for or g. Define the requirements for or design databases that support design databases that support analysis using geographic analysis using geographic information information

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I. Skill Domain—Assessment and Analysis

a. Maintain original data a. Maintain original data, but transform a. Ensure that data are maintained and a. Maintain original data, but transform b. N/A data as needed for specific analyses transformed as needed for specific data as needed for specific analyses c. Follow established procedures for b. Use national standards where they analyses b. Recommend national standards to creating new variables as necessary exist when creating datasets for b. Ensure that national standards are use when creating datasets for to support analysis of data analysis employed where they exist when analysis d. N/A c. Create new variables as necessary to datasets are created for analysis c. Evaluate need for creation of new e. Follow established procedures for support analysis of data c. N/A variables as necessary to support linking relational data and subsetting d. Perform merging and splitting of d. N/A analysis of data them into analysis-specific flat databases e. N/A d. Evaluate need for and perform datasets e. Determine methods for linking f. N/A merging and splitting of databases f. N/A relational data and subsetting them g. Ensure that all data transformations e. Recommend methods for linking g. Document all changes to database into analysis-specific flat datasets are documented relational data and subsetting them h. Apply practices for secure (restricted f. Change format of data from one h. Ensure secure (restricted access) and into analysis-specific flat datasets access) and stable (routine backups, software application to another if stable (routine backups, database f. Provide technical expertise in database redundancy) data storage necessary (e.g., from ASCII to SAS) redundancy) data storage changing format of data from one g. Document all data transformations software application to another if h. Apply practices for secure (restricted necessary (e.g., from ASCII to SAS) access) and stable (routine backups, g. Create processes for documenting database redundancy) data storage data transformations h. Ensure secure (restricted access) and stable (routine backups, database redundancy) data storage

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I. Skill Domain—Assessment and Analysis

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert F. Analyze data from an epidemiologic F. Analyze data from an epidemiologic F. Evaluate analysis of data from an F. Evaluate data from an epidemiologic investigation or study investigation or study epidemiologic investigation or study investigation or study

1. Use analysis plan for data 1. Create analysis plan for data 1. Approve analysis plan for data 1. Create analysis plan for data

a. N/A a. Define analysis plan to ensure that a. Ensure that analysis plan will meet a. Formulate analysis plan to ensure b. N/A public health objectives are met the public health objectives that public health objectives are met c. N/A b. Identify valid statistical techniques b. Validate the selected statistical b. Formulate valid statistical techniques d. Recognize and describe the given the data, study design, sample techniques given the data, study given the data, study design, sample assumptions to be used in size, hypotheses, and other relevant design, sample size, hypotheses, and size, hypotheses, and other relevant interpreting results factors other relevant factors factors e. N/A c. Specify the parameters to estimate c. N/A c. Verify the parameters selected for f. N/A d. Specify the assumptions to be used d. N/A estimation g. N/A in interpreting results e. N/A d. Verify the assumptions to be used in m. N/A e. Create datasets to be used in the f. N/A interpreting results analysis g. N/A e. Approve the selection of the datasets f. Select software for analyzing and for the analysis managing data f. Approve the selection of the g. Analyze data using geospatial and software to be used for analyzing and graphical representations managing data g. Recommend methods for analyzing the results including geospatial and other graphical representations

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I. Skill Domain—Assessment and Analysis

a. Compute frequencies and descriptive a. Compute frequencies and descriptive a. N/A a. Compute frequencies and descriptive statistics statistics b. N/A statistics b. Perform analyses for rates and age b. Determine whether rates and age c. N/A b. Determine whether rates and age adjustment as directed adjustments are needed and perform d. N/A adjustments are needed, and perform c. Compute sensitivity, specificity, analyses as necessary e. N/A analyses as necessary positive predictive value, incidence, c. Determine which standard f. N/A c. Formulate a synopsis of the data prevalence, and attributable fraction epidemiologic measures are g. N/A using standard epidemiologic as directed indicated (e.g., sensitivity, h. N/A measures, including sensitivity, d. N/A specificity, positive predictive value, i. Verify results and interpretation of specificity, positive predictive value, e. Perform analyses for measures of incidence, prevalence, and data analysis incidence, prevalence, and association (e.g., relative risks and attributable fraction), and compute as j. N/A attributable fraction odds ratios), confidence intervals, needed k. N/A d. Determine best methodology for and and p-values d. Perform trend analyses l. N/A perform trend analyses f. Interpret measures of association, e. Determine measures of association m. Review and approve resulting e. Analyze using measures of confidence intervals, and p-values (e.g., relative risks and odds ratios), epidemiology reports association (e.g., relative risks and g. N/A confidence intervals, and p-values, odds ratios), confidence intervals, h. N/A and perform analysis as needed and p-values i. N/A f. Interpret measures of association, f. Interpret measures of association, j. N/A confidence intervals, and p-values confidence intervals, and p-values k. N/A g. Assess need for multivariable g. Evaluate using multivariate and/or l. Create standard epidemiology report analyses regression analyses as necessary and necessary components, including h. Perform multivariable and/or h. Perform multivariable and/or tables, graphs, and charts regression analyses as necessary regression analyses as necessary m. N/A i. N/A i. Verify results and interpretation of j. Assess the effect of potential data analysis confounders j. Assess the effect of potential k. Assess whether effect modification is confounders present k. Assess whether effect modification is l. Create standard epidemiology report present and necessary components, including l. Create standard epidemiology report tables, graphs, and charts and necessary components, including m. Review and approve resulting tables and graphs epidemiology reports m. N/A

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I. Skill Domain—Assessment and Analysis

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert G. Summarize results of the analysis, G. Summarize results of the analysis, G. Evaluate conclusions and G. Evaluate results of the analysis, and and draw conclusions and draw conclusions interpretations from investigation interpret conclusions

1. N/A 1. Apply knowledge of epidemiologic 1. Assess the validity of the epidemiologic 1. Assess the validity of the epidemiologic principles and methods to make data, taking into consideration bias and data, taking into consideration bias and recommendations regarding the validity other study limitations other study limitations of epidemiologic data

a. N/A a. Determine likely sources of bias a. N/A a. Confirm likely sources of bias and b. N/A b. Assess validity and reliability of data b. N/A likely effects on results c. N/A collection instruments and methods c. N/A b. Verify the selection of data d. N/A c. Determine other limitations in study d. N/A collection instruments and methods e. Distinguish between statistical design, sample selection, data e. Evaluate causal inferences on the on the basis of their validity and association and causal effect collection, analysis, and other basis of principles of causation (e.g., reliability f. N/A features strength, consistency, biological c. Confirm other limitations in study d. Recognize the limitations of plausibility, dose-response, and design, sample selection, data significance testing temporal relationship) collection, analysis, and other e. Make causal inferences on the basis f. N/A features of principles of causation (e.g., d. Explain the limitations of strength, consistency, biological significance testing plausibility, dose-response, and e. Evaluate causal inferences on the temporal relationship) basis of principles of causation (e.g., f. Examine the influence of power and strength, consistency, biological confidence limits on the plausibility, dose-response, and interpretation of the study’s data temporal relationship) f. Explain the influence of power and confidence limits on the interpretation of the study’s data

2. N/A 2. Assess need for special analyses, 2. Assess need for special analyses, 2. Assess need for special analyses, including survival analyses, cost- including survival analyses, cost- including survival analyses, cost- effectiveness/cost benefit/cost utility effectiveness/cost benefit/cost utility effectiveness/cost benefit/cost utility analyses analyses analyses

a. N/A a. N/A a. N/A a. Formulate special analyses as necessary, including survival analyses, cost-effectiveness/cost benefit/cost utility analyses

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I. Skill Domain—Assessment and Analysis

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert 3. Identify key findings from the study 3. Identify key findings from the study 3. Validate key findings from the study 3. Synthesize key findings from the study

a. Relate study findings to current a. Interpret study’s results in the a. N/A a. Evaluate study’s results in the scientific knowledge context of current scientific b. Determine the importance of context of current scientific b. N/A knowledge implications to public health knowledge c. N/A b. Identify any implications to public programs b. Verify any implications to public health programs c. Synthesize results for health programs c. Communicate results communication to decision-makers c. Synthesize results for and the public communication to decision-makers and the public

H. Assist in developing recommended H. Recommend evidence-based H. Determine evidence-based H. Formulate new interventions on the evidence-based interventions and interventions and control measures interventions and control measures basis of evidence when available, and control measures in response to in response to epidemiologic findings in response to epidemiologic findings control measures in response to epidemiologic findings epidemiologic findings

1. Define cultural/social/political 1. Establish cultural/social/political 1. Approve interventions on the basis of 1. Examine cultural/social/political framework for recommended framework for recommendations or understanding of framework to develop recommendations interventions interventions cultural/social/political framework for or interventions consideration

a. Describe study data in a way that a. Describe study data in a way that a. N/A a. Describe study data in a way that makes clear the rationale for the makes clear the rationale for the b. Interpret study findings in the makes clear the rationale for the recommendations recommendations context of existing policies, recommendations b. N/A b. Relate study findings to existing regulations, and laws, as well as b. Evaluate study findings in relation to policies, regulations, and laws, as environmental factors (e.g., societal, existing policies, regulations, and well as environmental factors (e.g., cultural, or other factors that may laws, as well as environmental societal, cultural, or other factors that affect the recommendations or factors (e.g., societal, cultural, or may affect the recommendations or interventions) other factors that may affect the interventions) recommendations or interventions)

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I. Skill Domain—Assessment and Analysis

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert 2. N/A 2. Use scientific evidence in preparing 2. Ensure that scientific evidence is used in 2. Design recommendations using recommendations for action or preparing recommendations for action scientific evidence or interventions interventions or interventions a. N/A a. Synthesize scientific evidence and a. N/A a. Synthesize scientific evidence and b. N/A knowledge for use in preparing b. N/A knowledge for use in preparing c. N/A recommendations c. Approve assessment of the potential recommendations d. N/A b. Identify the key types of intervention impact on the public’s health from b. Evaluate the key types of e. N/A for problem alternative interventions intervention for problem f. N/A c. Develop assessment of the potential d. Select new recommendations or c. Evaluate the potential impact on the impact on the public’s health from modifications to existing public’s health from alternative alternative interventions interventions as necessary on the interventions d. Propose new recommendations or basis of study findings d. Formulate new recommendations or modifications to existing e. Approve prioritization of potential modifications to existing interventions as necessary on the public health interventions interventions as necessary on the basis of study findings f. Ensure that any recommended basis of study findings e. Prioritize potential public health behavioral interventions are linked e. Prioritize potential public health interventions with risk communication and risk interventions f. Link any recommended behavioral reduction methods f. Link any recommended behavioral interventions with risk interventions with risk communication and risk reduction communication and risk reduction methods methods I. Assist in evaluation of programs I. Evaluate programs I. Ensure evaluation of programs I. Evaluate programs 1. N/A 1. Assist in development of measurable 1. Approve measurable and program- 1. Develop measurable and program- and program-relevant goals and relevant goals and objectives relevant goals and objectives in objectives collaboration with program staff 2. N/A 2. Assist in development of program logic 2. Decide on program logic models and 2. Develop program logic models and models and theories of action theories of action theories of action in collaboration with program staff 3. Collect surveillance and other data for 3. Identify surveillance and other data for 3. Approve surveillance and other data for 3. Synthesize surveillance and other data use in tracking program objectives and use in tracking program objectives and use in tracking program objectives and to allow tracking of program objectives outcomes outcomes outcomes and outcomes 4. Assist in tracking progress toward 4. Record progress toward program 4. Monitor progress toward program 4. Critique progress toward program program objectives and outcomes objectives and outcomes objectives and outcomes objectives and outcomes 5. Communicate information about 5. Communicate information about 5. Incorporate information about progress 5. Evaluate progress toward program progress toward program objectives and progress toward program objectives and toward program objectives and objectives and outcomes for program outcomes to program managers outcomes to program managers and outcomes in decisions on program managers and staff to aid in program staff for use in program planning and planning and modification planning and modification modification

Centers for Disease Control and Prevention / Council of State and Territorial Epidemiologists February 2008 version 1.2 16 CDC/CSTE Competencies for Applied Epidemiologists in Governmental Public Health Agencies

II. Skill Domain—Basic Public Health Sciences

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert A. Know how causes of disease affect A. Use current knowledge of causes of A. Use current knowledge of causes of A. Use current knowledge of causes of epidemiologic practice disease to guide epidemiologic disease to guide epidemiologic disease to guide epidemiologic practice practice practice

1. Relate basic etiologic processes for 1. Relate basic etiologic processes for 1. Ensure that basic etiologic processes for 1. Ensure that basic etiologic processes for human diseases to subject matter areas human diseases to subject matter areas human diseases are related to subject human diseases are related to subject of interest (e.g., infectious diseases, of interest (e.g., infectious diseases, matter areas of interest (e.g., infectious matter areas of interest (e.g., infectious chronic diseases) chronic diseases) diseases, chronic diseases) diseases, chronic diseases)

2. Apply understanding of human and 2. Apply understanding of human and 2. Ensure the application of understanding 2. Ensure the application of understanding environmental biology and behavioral environmental biology and behavioral of human and environmental biology of human and environmental biology sciences and principles to determine sciences and principles to determine and behavioral sciences and principles and behavioral sciences and principles potential biological mechanisms of potential biological mechanisms of to determine potential biological to determine potential biological disease disease mechanisms of disease mechanisms of disease

3. N/A 3. Explain how genetics and genomics 3. Ensure that the role of genetics and 3. Synthesize knowledge about the effect affect disease processes and public genomics on disease processes are of genetics and genomics on disease health policy and practice considered when developing public processes and public health policy and health policy and practice practice

4. Apply principles of the 4. Apply principles of the 4. Ensure the application of principles of 4. Ensure the application of principles of host/agent/environment model to host/agent/environment model to the host/agent/environment model to the host/agent/environment model to disease causation, prevention, and disease causation, prevention, and disease causation, prevention, and disease causation, prevention, and control control control control

5. Describe the role and influence of 5. Describe the role and influence of 5. Ensure that the role and influence of 5. Synthesize knowledge about the role sociobehavioral factors (including sociobehavioral factors (including sociobehavioral factors (including and influence of sociobehavioral factors community, political, social, family, community, political, social, family, community, political, social, family, (including community, political, social, and individual behavioral factors) in and individual behavioral factors) in and individual behavioral factors) are family, and individual behavioral health risks and health status health risks and health status incorporated into understanding health factors) in health risks and health status risks and health status

6. N/A 6. Incorporate etiologic principles into 6. Incorporate etiologic principles into 6. Incorporate etiologic principles into development of disease prevention and development of disease prevention and development of disease prevention and control strategies control strategies control strategies

Centers for Disease Control and Prevention / Council of State and Territorial Epidemiologists February 2008 version 1.2 17 CDC/CSTE Competencies for Applied Epidemiologists in Governmental Public Health Agencies

II. Skill Domain—Basic Public Health Sciences

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert B. Identify the role of laboratory B. Use laboratory resources to support B. Ensure the use of laboratory B. Develop processes for using resources in epidemiologic activities epidemiologic activities resources to support epidemiologic laboratory resources to support activities epidemiologic activities 1. Identify the roles and capabilities of 1. Identify the roles and capabilities of 1. Examine the roles and capabilities of 1. Synthesize the roles and capabilities of public health laboratories and other public health laboratories and other public health laboratories and other public health laboratories in laboratories and how they are used in laboratories and how they are used in laboratories and how they are used in epidemiologic investigations epidemiologic investigations epidemiologic investigations epidemiologic investigations

2. N/A 2. Coordinate laboratory and 2. Ensure the coordination of laboratory 2. Determine laboratory and epidemiologic activities, including test and epidemiologic activities, including epidemiologic activities including test selection, communication, and reporting test selection, communication, and selection, communication, and reporting results in the field reporting results in the field results in the field

3. N/A 3. Interpret laboratory data, accounting for 3. Evaluate the interpretation of laboratory 3. Develop methods for the interpretation factors that influence the results of data accounting for factors that of laboratory data, accounting for screening and diagnostic tests influence the results of screening and factors that influence the results of diagnostic tests screening and diagnostic tests

4. Use identified specimen collection, 4. Implement necessary specimen 4. Oversee necessary specimen collection, 4. Develop methods for specimen storage, and transportation measures collection, storage, and transportation storage, and transportation measures collection, storage, and transportation measures measures C. Use identified informatics tools in C. Apply principles of informatics, C. Ensure application of principles of C. Apply principles of informatics, support of epidemiologic practice including data collection, processing, informatics, including data including data collection, processing, and analysis, in support of collection, processing, and analysis, and analysis, in support of epidemiologic practice in support of epidemiologic practice epidemiologic practice 1. Use information technologies and 1. Use information technologies and 1. Provide access to information 1. Use information technologies and communication tools necessary to communication tools necessary to technologies and communication tools communication tools necessary to support epidemiologic investigations support epidemiologic investigations necessary to support epidemiologic support epidemiologic investigations and surveillance and surveillance investigations and surveillance and surveillance

2. Use software tools that support public 2. Use software tools that support online 2. Provide access to software tools that 2. Use software tools that support online health data acquisition, entry, searching, public health data support online searching, public health searching, public health data abstraction, analysis, and reporting acquisition, entry, abstraction, data acquisition, entry, abstraction, acquisition, entry, abstraction, management, analysis, planning, management, analysis, planning, management, analysis, planning, mapping, and reporting mapping, and reporting mapping, and reporting

3. Apply procedures (policies) and 3. Apply procedures (policies) and 3. Assure that procedures (policies) and 3. Apply procedures (policies) and technical means (security) to ensure the technical means (security) to ensure the technical means (security) are used to technical means (security) to ensure the integrity and protection of confidential integrity and protection of confidential ensure the integrity and protection of integrity and protection of confidential information in electronic files and information in electronic files and confidential information in electronic information in electronic files and computer systems computer systems files and computer systems computer systems

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II. Skill Domain—Basic Public Health Sciences

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert 4. Combine data and information from 4. Combine data and information from 4. Use data and information from multiple 4. Synthesize data and information from multiple sources to create new multiple sources to create new sources to create new information to multiple sources to create new information to support public health information to support public health support public health decision-making information to support public health decision-making decision-making decision-making

a. Suggest limitations of current data a. Determine whether new data a. Decide whether to create new data a. Decide whether to create new data collection that might determine the collection is needed or existing collection systems or to mine collection systems or to mine need for new data collection datasets or systems can be mined existing datasets or systems existing datasets or systems b. N/A b. Participate in the development of b. Oversee the development of new or b. Develop new or enhance existing c. N/A new or enhancement of existing enhancement of existing databases to databases to support epidemiologic d. N/A databases to support epidemiologic support epidemiologic investigations, surveillance, etc. investigations, surveillance, etc. investigations, surveillance, etc. c. Ensure the utilization of c. Use interoperable data standards as c. Ensure the utilization of interoperable data standards for needed for storage and transmission, interoperable data standards for storage and transmission, and be able and be able to find the relevant storage and transmission, and be able to find the relevant standards standards specifications as needed to find the relevant standards specifications as needed d. Maintain electronic documents specifications as needed d. Create processes to maintain (guidelines, datasets), including d. Maintain electronic documents electronic documents (guidelines, documented versions, dissemination (guidelines, datasets), including datasets), including documented methods, and relevant standards documented versions, dissemination versions, dissemination methods, and specifications methods, and relevant standards relevant standards specifications specifications

5. N/A 5. Participate in development of data 5. Participate in development of data 5. Participate in development of data models to ensure representation of models to ensure representation of models to ensure representation of epidemiologic needs in associated epidemiologic needs in associated epidemiologic needs in associated databases and information systems databases and information systems databases and information systems

D. N/A D. N/A D. Develop and manage information D. Develop and manage information systems to improve effectiveness of systems to improve effectiveness of surveillance, investigation, and other surveillance, investigation, and other epidemiologic practices epidemiologic practices

1. N/A 1. N/A 1. Engage and consult with information 1. N/A technology professionals with necessary expertise for developing information systems to support epidemiology programs

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II. Skill Domain—Basic Public Health Sciences

3. N/A 3. N/A 3. Ensure that all members of systems 3. Compose and manage systems development teams, including development teams in a manner that epidemiologists and information demonstrates recognition of the technology specialists, fill roles appropriate roles and domains for consistent with their expertise computer scientists, epidemiologists, policy makers, and programmers and other information technology specialists in information systems development

4. N/A 4. N/A 4. Lead the development of integrated, 4. Lead and advocate for, or otherwise cost-effective public health information actively participate in, the development systems that are consistent with a larger of integrated, cost-effective public (enterprise-level) information health information systems within the architecture public health enterprise, ensuring that new applications and information systems are built in conformance with a larger (enterprise-level) information architecture

5. N/A 5. N/A 5. Participate in development of 5. Participate in development of confidentiality and privacy policies for confidentiality and privacy policies for the enterprise and security systems to the enterprise, and ensure the support the implementation of those development of security systems to policies support the implementation of those policies

6. N/A 6. N/A 6. Ensure that information systems 6. Ensure that the information systems developed for epidemiology programs developed for epidemiology programs fully support the objectives, functions, fully support the objectives, functions, and business processes of the public and business processes of the public health system health system

Centers for Disease Control and Prevention / Council of State and Territorial Epidemiologists February 2008 version 1.2 20 CDC/CSTE Competencies for Applied Epidemiologists in Governmental Public Health Agencies

III. Skill Domain—Communication

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert A. Prepare written and oral reports and A. Prepare written and oral reports and A. Ensure preparation of written and A. Organize preparation of written and presentations that communicate presentations that communicate oral reports and presentations that oral reports and presentations that necessary information to agency staff necessary information to communicate necessary information communicate necessary information professional audiences, policy to professional audiences, policy to professional audiences, policy makers, and the general public makers, and the general public makers, and the general public 1. Identify methods and content for 1. Identify audience, methods, and content 1. Approve selection of audience, 1. Verify selection of audience, methods, communication of epidemiologic for communication of epidemiologic methods, and content for and content for communication of findings findings communication of epidemiologic epidemiologic findings findings a. N/A a. Identify target audience for a. N/A a. Decide on target audience for b. Identify relevant data to report communication b. N/A communication c. Assess needs and interests of target b. Identify relevant data to report c. N/A b. Determine relevance of data to report audience for materials that are used c. Assess needs and interests of target d. N/A c. Review assessment of needs and in communication audience for materials that are used interests of target audience for d. Use communication methods that in communication materials that are used in meet the needs of the target d. Identify communication methods communication audience, as directed that meet the needs of the target d. Verify methods of communication audience selected for target audience 2. Communicate epidemiologic work to 2. Communicate epidemiologic work to 2. Review written reports and oral 2. Create written reports and oral agency staff through written reports and professional audiences and agency staff presentations to ensure that content presentations that communicate oral presentations through written reports and oral communicates epidemiologic work to epidemiologic work to professional presentations professional audiences and agency staff audiences and agency staff a. N/A a. Prepare abstracts either for a. N/A a. Prepare abstracts either for b. N/A publication or for presentation at b. N/A publication or for presentation at c. Prepare summary reports and scientific meetings c. N/A scientific meetings memoranda for use within the b. Prepare manuscripts for scientific d. N/A b. Prepare manuscripts for scientific agency publication e. N/A publication d. N/A c. Prepare summary reports and f. N/A c. Prepare summary reports and e. Use current audiovisual tools to memoranda for use within the memoranda for use within the maximize communication agency agency f. Create charts, tables, and figures that d. N/A d. Critique reports, manuscripts, and communicate to the target audience e. Use current audiovisual tools to other documents that have been maximize communication prepared by others f. Create charts, tables, and figures that e. Use current audiovisual tools to communicate to the target audience maximize communication f. Create charts, tables, and figures that communicate to the target audience

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III. Skill Domain—Communication

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert 3. N/A 3. Communicate epidemiologic 3. Create processes to guide preparation of 3. Create documents (e.g., briefs, press information to the general public, the documents or oral presentations that releases, Web pages) that communicate news media, and/or to policy makers communicate epidemiologic epidemiologic information to the through giving oral presentations or information to the general public, news general public, press, and/or to policy contributing to development of written media, and/or policy makers makers documents

a. N/A a. Contribute to press releases for the a. Approve press releases on an as- a. Contribute to or develop press b. N/A general public needed basis releases for the general public c. N/A b. Participate in the development of b. N/A b. Develop disease prevention/health disease prevention/health promotion c. Create documents that communicate promotion materials for lay materials for lay audiences scientific findings in a language audiences c. Communicate scientific findings in a tailored to the needs of decision- c. Create documents that communicate language tailored to the needs of makers, news media, and other target scientific findings in a language decision-makers, news media, and audiences tailored to the needs of decision- other target audiences makers, news media, and other target audiences

4. N/A 4. Tailor surveillance information content 4. Approve surveillance information 4. Determine content for surveillance and periodicity of dissemination for content and periodicity of dissemination information and periodicity of specific audiences and their uses for specific audiences and their uses dissemination for specific audiences and their uses

5. Respond to public queries about 5. Respond to public queries about 5. Oversee responses to public queries 5. Create key messages for responding to epidemiologic data epidemiologic data or related issues about epidemiologic data or related public queries about epidemiologic data issues or related issues

6. N/A 6. Demonstrate ability to explain or teach 6. Demonstrate ability to explain or teach 6. Demonstrate ability to explain or teach basic epidemiologic principles to non- basic epidemiologic principles to non- basic and advanced epidemiologic epidemiologists and lower-level epidemiologists and lower-level principles to non-epidemiologists and epidemiologists epidemiologists lower-level epidemiologists

Centers for Disease Control and Prevention / Council of State and Territorial Epidemiologists February 2008 version 1.2 22 CDC/CSTE Competencies for Applied Epidemiologists in Governmental Public Health Agencies

III. Skill Domain—Communication

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert B. Recognize the basic principles of risk B. Demonstrate the basic principles of B. Ensure that the basic principles of B. Create messages that follow the communication risk communication risk communication are followed in principles of risk communication all communication of epidemiologic findings

1. Provide epidemiologic information to 1. Participate in developing risk 1. Develop risk communication messages 1. Develop risk communication messages support the development of risk communication messages that convey that convey epidemiologic information that convey epidemiologic information communication messages epidemiologic information to particular to particular public health problems to particular public health problems public health problems

a. N/A a. Assist in developing content for risk a. Create content for risk a. Create content for risk b. Provide content to the public communication messages communication messages communication messages information officer and other b. Provide content to the public b. Review the content provided to the b. Review and provide content to the relevant agency staff information officer and other public information officer and other public information officer and other c. N/A relevant agency staff relevant agency staff relevant agency staff c. Review risk communication c. Review risk communication c. Review risk communication messages for scientific accuracy and messages for scientific accuracy and messages for scientific accuracy and clarity clarity clarity

2. Use basic risk communication 2. Use basic risk communication 2. Oversee communication of 2. Model risk communication principles principles to communicate principles to communicate epidemiologic messages when communicating epidemiologic epidemiologic messages to agency staff epidemiologic messages messages

a. Refer media inquiries to the correct a. Refer media inquiries to the correct a. Ensure that staff refer media a. Refer media inquiries to the correct spokesperson for the agency spokesperson for the agency inquiries to the correct spokesperson spokesperson for the agency b. N/A b. N/A for the agency b. Serve as agency spokesperson when c. N/A c. Respond to media inquiries as b. Serve as agency spokesperson when necessary d. N/A requested by the public health necessary c. Respond to media inquiries e. Adhere to the agency risk agency c. Respond to media inquiries d. N/A communication strategy d. N/A d. Ensure that staff are using risk e. Adhere to the agency risk e. Adhere to the agency risk communication techniques suitable communication strategy communication strategy to the target audience e. Adhere to the agency risk communication strategy

Centers for Disease Control and Prevention / Council of State and Territorial Epidemiologists February 2008 version 1.2 23 CDC/CSTE Competencies for Applied Epidemiologists in Governmental Public Health Agencies

III. Skill Domain—Communication

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert C. Incorporate interpersonal skills in C. Incorporate interpersonal skills in C. Model interpersonal skills in C. Model interpersonal skills in communication with agency communication with agency communication with agency communication with agency personnel, colleagues, and the public personnel, colleagues, and the public personnel, colleagues, and the public personnel, colleagues, and the public

1. Demonstrate ability to listen effectively 1. Demonstrate ability to listen effectively 1. Demonstrate ability to listen effectively 1. Demonstrate ability to listen effectively when epidemiologic findings are when epidemiologic findings are when epidemiologic findings are when epidemiologic findings are presented or discussed presented or discussed presented or discussed presented or discussed

2. Demonstrate professional interpersonal, 2. Demonstrate professional interpersonal, 2. Model professional interpersonal, 2. Model professional interpersonal, interdisciplinary, transdisciplinary, and interdisciplinary, transdisciplinary, and interdisciplinary, transdisciplinary, and interdisciplinary, transdisciplinary, and multidisciplinary communication multidisciplinary communication multidisciplinary communication multidisciplinary communication

a. Participate in discussions and in a. Lead discussions and participate in a. Promote group discussions and lead a. Lead discussions and participate in group settings group settings such discussions when necessary group settings b. Show respect for others and promote b. Show respect for others and promote b. Show respect for others and promote b. Show respect for others and promote diverse opinions diverse opinions diverse opinions diverse opinions c. Demonstrate ability to solicit input c. Demonstrate ability to solicit input c. Solicit input from individuals and c. Demonstrate ability to solicit input from individuals and groups from individuals and groups groups from individuals and groups d. Demonstrate ability to communicate d. Demonstrate ability to communicate d. Create messages to communicate d. Create messages to communicate epidemiologic findings, epidemiologic findings, epidemiologic findings, epidemiologic findings, methodology, and principles when methodology, and principles when methodology, and principles to methodology, and principles to part of a multidisciplinary team part of a multidisciplinary team multidisciplinary teams multidisciplinary teams e. Demonstrate ability to interview e. Demonstrate ability to interview e. N/A e. N/A individuals associated with disease individuals associated with disease f. Use communication skills to help f. Use communication skills to help investigations investigations resolve conflict resolve conflict f. Use communication skills to help f. Use communication skills to help g. Create messages that communicate g. Create messages that communicate resolve conflict resolve conflict findings to affected individuals or findings to affected individuals or g. Support communication of findings g. Communicate findings to affected communities using mechanisms communities using mechanisms to affected individuals or individuals or communities using tailored to that individual or tailored to that individual or communities using mechanisms mechanisms tailored to that community/special population community/special population tailored to that individual or individual or community/special community/special population population

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III. Skill Domain—Communication

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert D. Use effective communication D. Use effective communication D. Ensure utilization of effective D. Use effective communication technologies technologies communication technologies technologies

1. Participate in the development of the 1. Participate in the development of the 1. Approve the design and content of 1. Create content for Web-based design and content of Web-based design and content of Web-based Web-based communication communication communication communication

2. Use policies that address security, 2. Use policies that address security, 2. Enforce policies that address security, 2. Develop as-needed policies that address privacy, and legal considerations when privacy, and legal considerations when privacy, and legal considerations when security, privacy, and legal communicating epidemiologic communicating epidemiologic communicating epidemiologic considerations when communicating information through e-mail, health alert information through e-mail, health alert information through e-mail, health alert epidemiologic information through e- networks, or other potentially public networks, or other potentially public networks, or other potentially public mail, health alert networks, or other documents documents documents potentially public documents

3. N/A 3. Use effective educational and 3. Use effective educational and 3. Use effective educational and behavioral techniques and technological behavioral techniques and technological behavioral techniques and technological tools to promote public health (e.g., tools to promote public health (e.g., tools to promote public health (e.g., through community education, behavior through community education, behavior through community education, behavior modification, collaborative policy modification, collaborative policy modification, collaborative policy development, issue advocacy, and development, issue advocacy, and development, issue advocacy, and community mobilization) community mobilization) community mobilization)

Centers for Disease Control and Prevention / Council of State and Territorial Epidemiologists February 2008 version 1.2 25 CDC/CSTE Competencies for Applied Epidemiologists in Governmental Public Health Agencies

IV. Skill Domain—Community Dimensions of Practice

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert A. Provide epidemiologic input into A. Provide epidemiologic input into A. Lead epidemiologic studies, public A. Lead epidemiologic studies, public epidemiologic studies, public health epidemiologic studies, public health health programs, and community health programs, and community programs, and community public programs, and community public public health planning processes at public health planning processes at health planning processes at the health planning processes at the the state, local, or tribal level the state, local, or tribal level state, local, or tribal level state, local, or tribal level

1. Supply information from health status 1. Use information from the community 1. Synthesize information from the 1. Synthesize information from the assessments to aid in the design, and from health status assessments to community and from health status community and from health status interpretation, and conduct of aid in the design, interpretation, and assessments to aid in the design, assessments to aid in the design, epidemiologic studies conduct of epidemiologic studies interpretation, and conduct of interpretation, and conduct of epidemiologic studies epidemiologic studies

a. N/A a. Use strategies for engaging a. Engage communities in dialogue on a. Engage communities in dialogue on b. N/A communities in dialogue on health health issues requiring study health issues requiring study c. Provide communities with data as issues requiring study b. Ensure outreach to populations and b. Ensure outreach to populations and directed to aid in identifying health b. Use strategies for reaching individuals who traditionally may individuals who traditionally may priorities for study populations and individuals who not have had the opportunity to not have had the opportunity to d. Provide technical assistance as traditionally may not have had the participate in priority-setting participate in priority-setting directed to communities and outside opportunity to participate in priority- processes processes partners with respect to surveillance, setting processes c. Provide leadership to communities in c. Provide leadership to communities in epidemiologic data, and evaluation c. Assist communities in identifying identifying health priorities for study identifying health priorities for study health priorities for study d. Provide technical assistance to d. Provide technical assistance to d. Provide technical assistance to communities and outside partners communities and outside partners communities and outside partners with respect to surveillance, with respect to surveillance, with respect to surveillance, epidemiologic data, and evaluation epidemiologic data, and evaluation epidemiologic data, and evaluation

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IV. Skill Domain—Community Dimensions of Practice

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert 2. Assist in providing epidemiologic input 2. Provide epidemiologic input into an 2. Lead epidemiologic portion of 2. Lead epidemiologic portion of into an assessment of the local public assessment of the local public health assessment of the local public health assessment of the local public health health system to aid in state, local, or system to aid in state, local, or tribal system to aid in state, local, or tribal system to aid in state, local, or tribal tribal public health planning public health planning public health planning public health planning

a. N/A a. Map the different levels of a. Ensure that the different levels of a. Map the different levels of b. N/A government public health (tribal, government public health (tribal, government public health (tribal, c. N/A local, state, and federal) and their local, state, and federal) and their local, state, and federal) and their d. Assist in identifying the specific roles and responsibilities in the roles and responsibilities are mapped roles and responsibilities in the populations within the community or community out in the community community region that each public health b. Characterize the interactions b. Ensure that the interactions between b. Characterize the interactions program seeks to reach between different levels of different levels of government in between different levels of e. Assist in identifying the government in relation to community relation to community public health government in relation to community epidemiologic data collection and public health programs programs are characterized public health programs analysis needs of each program c. Assess the funding streams for c. Assess the funding streams for c. Assess the funding streams for f. N/A public health and epidemiology public health and epidemiology public health and epidemiology g. N/A programs that affect the community programs that affect the community programs that affect the community h. N/A d. Identify the specific populations d. Ensure that the specific populations d. Identify the specific populations i. N/A within the community or region that within the community or region that within the community or region that j. N/A each public health program seeks to each public health program seeks to each public health program seeks to k. N/A reach reach are identified reach e. Identify the epidemiologic data e. Ensure that the epidemiologic data e. Identify the epidemiologic data collection and analysis needs of each collection and analysis needs of each collection and analysis needs of each program program are identified program f. N/A f. Identify community themes and f. Identify community themes and g. Map the community medical-care strengths strengths delivery system, including financing g. Ensure that the community medical- g. Map the community medical-care and structure and major policy issues care delivery system is mapped out, delivery system, including financing affecting medical care including financing and structure and and structure and major policy issues h. Characterize relationships among major policy issues affecting medical affecting medical care public and private organizations care h. Characterize relationships among within the community h. Ensure that relationships among public and private organizations i. Identify environmental, social, and public and private organizations within the community cultural factors that affect the within the community are i. Evaluate environmental, social, and community’s health characterized cultural factors that affect the j. Document changes that are occurring i Ensure that environmental, social, community’s health or are expected to occur that affect and cultural factors that affect the j Examine changes that are occurring the community’s health or the local community’s health are analyzed or are expected to occur that affect public health system (e.g., a the community’s health or the local Mobilizing for Action through public health system (e.g., a Planning and Partnerships forces of Mobilizing for Action through change assessment) Planning and Partnerships forces of change assessment)

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IV. Skill Domain—Community Dimensions of Practice

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert 2. Provide epidemiologic input into an 2. Lead epidemiologic portion of 2. Lead epidemiologic portion of assessment of the local public health assessment of the local public health assessment of the local public health system to aid in state, local, or tribal system to aid in state, local, or tribal system to aid in state, local, or tribal public health planning (continued) public health planning (continued) public health planning (continued)

k. Identify threats and opportunities j. Examine changes that are occurring k. Evaluate threats and opportunities that arise from these changes or are expected to occur that affect that arise from these changes the community’s health or the local public health system (e.g., a Mobilizing for Action through Planning and Partnerships forces of change assessment) k. Evaluate threats and opportunities that arise from these changes

B. Participate in development of B. Participate in development of B. Develop community partnerships to B. Develop community partnerships to community partnerships to support community partnerships to support support epidemiologic investigations support epidemiologic investigations epidemiologic investigations epidemiologic investigations

1. N/A 1. Identify partners and stakeholders 1. Sustain relationships with partners and 1. Solicit partners and stakeholders necessary for epidemiologic stakeholders necessary for necessary for epidemiologic investigation epidemiologic investigation investigation

2. Contribute to community-specific 2. Use community-specific participation 2. Ensure the use of community-specific 2. Develop community-specific participation strategies to engage the strategies in the planning, participation strategies in the planning, participation strategies in the planning, public in the planning, implementation, implementation, and evaluation of implementation, and evaluation of implementation, and evaluation of and evaluation of epidemiologic epidemiologic investigations when epidemiologic investigations when epidemiologic investigations when investigations when indicated indicated indicated indicated

3. N/A 3. Clarify the roles of partners and 3. Clarify the roles of partners and 3. Clarify the roles of partners and stakeholders in the epidemiologic stakeholders in the epidemiologic stakeholders in the epidemiologic investigation investigation investigation

4. N/A 4. Participate in the development of 4. Lead the development of epidemiologic 4. Lead the development of epidemiologic epidemiologic studies, including studies, including incorporating input studies, including incorporating input incorporating input from task forces and from task forces and other target from task forces and other target other target audiences audiences audiences

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V. Skill Domain—Cultural Competency

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert A. Describe population by race; A. Describe population by race; A. Differentiate special populations by A. Differentiate special populations by ethnicity; culture; societal, ethnicity; culture; societal, race; ethnicity; culture; societal, race; ethnicity; culture; societal, educational, and professional educational, and professional educational, and professional educational, and professional backgrounds; age; gender; religion; backgrounds; age; gender; religion; backgrounds; age; gender; religion; backgrounds; age; gender; religion; disability; and sexual orientation disability; and sexual orientation disability; and sexual orientation disability; and sexual orientation

1. Identify special populations in the 1. Identify special populations in the 1. Ensure that each special population is 1. Characterize each special population by community that may be significant in community that may be significant in characterized by size, location, and size, location, and other factors that addressing public health problems addressing public health problems other factors that may be significant in may be significant in addressing public addressing public health problems health problems

B. Establish relationships with groups B. Establish relationships with groups B. Establish relationships with groups B. Establish relationships with groups of special concern (e.g., of special concern (e.g., of special concern (e.g., of special concern (e.g., disadvantaged or minority groups, disadvantaged or minority groups, disadvantaged or minority groups, disadvantaged or minority groups, groups subject to health disparities, groups subject to health disparities, groups subject to health disparities, groups subject to health disparities, historically underrepresented historically underrepresented historically underrepresented historically underrepresented groups) groups) groups) groups)

1. N/A 1. Study populations’ histories and past 1. Evaluate populations’ histories and past 1. Evaluate historical context of treatment by public health system treatment by public health system populations’ histories and past treatment by public health system

2. N/A 2. N/A 2. Formulate communication strategies for 2. Formulate communication strategies for special populations on the basis of special populations on the basis of knowledge of historical treatment knowledge of historical treatment

3. N/A 3. N/A 3. Organize outreach efforts to special 3. Organize outreach efforts to special populations populations

4. N/A 4. Develop mechanisms to receive input 4. Ensure that input from groups of special 4. Ensure that input from groups of special from groups of special concern into the concern is used in the design and concern is used in the design and design and conduct of epidemiologic conduct of epidemiologic practice conduct of epidemiologic practice practice

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V. Skill Domain—Cultural Competency

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert C. Describe surveillance systems that C. Design surveillance systems to C. Ensure that surveillance systems are C. Ensure that surveillance systems are include groups subject to health include groups subject to health designed to include groups subject to designed to include groups subject to disparities or other potentially disparities or other potentially health disparities or other potentially health disparities or other potentially underrepresented groups (using underrepresented groups (using underrepresented groups (using underrepresented groups (using standard categories where available) standard categories where available) standard categories where available) standard categories where available)

1. Identify standard categories used to 1. Use standard categories when defining 1. Ensure that standard categories are used 1. Select standard categories used to define special populations special populations to define special populations, taking define special populations into account historical, social, and political contexts of standard categories

2. Identify historical, social, and political 2. Identify historical, social, and political 2. N/A 2. Examine historical, social, and political contexts of standard categories contexts of standard categories contexts of standard categories

3. Identify limitations of standard 3. Identify limitations of standard 3. N/A 3. Explain limitations of standard categories categories categories

4. N/A 4. Work with community as necessary to 4. Lead collaboration with community as 4. Work with community as necessary to develop new categories if standard necessary to develop new categories if develop new categories if standard categories are unavailable standard categories are unavailable categories are unavailable

5. N/A 5. Design data collection tools to capture 5. Ensure that data collection tools and 5. Verify that data collection tools will information needed to assess health sampling plan capture information capture information needed to assess disparities needed to assess health disparities and health disparities provide stable estimates in populations of interest

6. N/A 6. Design sampling plan to ensure sample 6. N/A 6. Evaluate sampling plan to ensure size large enough to provide stable sample size large enough to provide estimates in populations of interest stable estimates in populations of interest

7. Avoid potential adverse impacts of data 7. Avoid potential adverse impacts of data 7. Ensure that data collection does not 7. Avoid potential adverse impacts of data collection on special populations collection on special populations adversely impact special populations collection on special populations

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V. Skill Domain—Cultural Competency

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert D. Conduct investigations using D. Conduct investigations using D. Ensure that investigations use D. Organize investigations that use languages and approaches tailored languages and approaches tailored languages and approaches tailored languages and approaches tailored to population to population to population to population

1. Identify primary language of population 1. Identify primary language of population 1. Identify primary language of population 1. Identify primary language of population

2. Use knowledge of specific sociocultural 2. Use knowledge of specific sociocultural 2. Use knowledge of specific sociocultural 2. Use knowledge of specific sociocultural factors in the population factors in the population factors in the population factors in the population

3. N/A 3. N/A 3. Identify mechanisms for contact and 3. Identify mechanisms for contact and communication with population communication with population

4. N/A 4. N/A 4. Ensure that investigative methods will 4. Identify investigative methods that will accommodate special needs of the accommodate special needs of the population population

5. N/A 5. N/A 5. Synthesize this knowledge into an 5. Synthesize this knowledge into an investigation strategy investigation strategy

6. N/A 6. N/A 6. Facilitate staff access to identified 6. N/A support or mechanisms needed to communicate with population

E. Use standard population categories E. Use standard population categories E. Ensure that standard population E. Ensure that standard population or subcategories when performing or subcategories when performing categories or subcategories are used categories or subcategories are used data analysis data analysis for data analysis for data analyses

F. N/A F. Use knowledge of specific F. Use knowledge of specific F. Use knowledge of specific sociocultural factors in the sociocultural factors in the sociocultural factors in the population to interpret findings population to interpret findings population to interpret findings

1. N/A 1. Identify cultural factors that may have 1. Evaluate cultural factors that may have 1. Evaluate cultural factors that may have influenced outcome of investigation influenced outcome of investigation influenced outcome of investigation

2. N/A 2. N/A 2. Assess impact of investigation findings 2. Assess impact of investigation findings on the population on the population

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V. Skill Domain—Cultural Competency

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert G. Support public health actions that G. Recommend public health actions G. Ensure that actions are relevant to G. Recommend actions that will be are relevant to the affected that would be relevant to the affected the affected community relevant to the affected community community community

1. Use alternative actions that have been 1. Use alternative actions that have been 1. Ensure use of alternative actions that 1. Evaluate alternative actions that have shown to be effective in similar shown to be effective in similar have been shown to be effective in been shown to be effective in similar populations populations similar populations populations

2. Use action strategies that will address 2. Use action strategies that will address 2. Create action strategies that will address 2. Create action strategies that will address the issues identified in the investigation the issues identified in the investigation the issues identified in the investigation the issues identified in the investigation while meeting the needs of the while meeting the needs of the while meeting the needs of the while meeting the needs of the community community community community

3. N/A 3. N/A 3. Validate the choice of action strategy 3. Validate the choice of action strategy through consultation with the affected through consultation with the affected community community

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VI. Skill Domain—Financial and Operational Planning and Management (Operational Planning, Financial Planning, and Management Skills)

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert A. Conduct epidemiologic activities A. Conduct epidemiologic activities A. Create operational and financial A. Conduct epidemiologic activities within the financial and operational within the financial and operational plans for future epidemiologic within the financial and operational plan of the agency plan of the agency activities plan of the agency

1. N/A 1. Set goals and objectives for 1. Set goals and objectives for 1. Provide input into goals and objectives epidemiology program epidemiology program for epidemiology program

2. N/A 2. Formulate tasks to meet goals and 2. Formulate tasks to meet goals and 2. Formulate tasks to meet goals and objectives objectives objectives

3. Construct a timeline for carrying out the 3. Construct a timeline for carrying out the 3. Construct a timeline for carrying out the 3. Construct a timeline for carrying out the tasks tasks tasks tasks

4. Conduct epidemiologic activities, 4. Describe personnel, staffing, travel, and 4. N/A 4. Describe personnel, staffing, travel, and including travel, within specified budget other needs for epidemiologic activities other needs for epidemiologic activities

5. Maintain accurate records 5. Maintain accurate records 5. N/A 5. Maintain accurate records

B. Describe the financial planning and B. Assist in developing a fiscally sound B. Formulate a fiscally sound budget B. Describe the financial planning and budgetary process of the budget that will support the activities that will support the activities defined budgetary process of the agency epidemiology program defined in the operational plan and in the operational plan and is is consistent with the financial rules consistent with the financial rules of of the agency the agency

1. N/A 1. Assess the financial rules of the agency 1. Assess the financial rules of the agency 1. Assess the financial rules of the agency and available resources to establish and available resources to establish and available resources to establish boundaries for the budget boundaries for the budget boundaries for the budget

2. List resources necessary to carry out 2. Estimate resources necessary to carry 2. Justify resources necessary to carry out 2. Estimate resources necessary to carry tasks in the operational plan, including out tasks in the operational plan, tasks in the operational plan, including out tasks in the operational plan, personnel, equipment, supplies, and including personnel, equipment, personnel, equipment, supplies, and including personnel, equipment, travel costs supplies, and travel costs travel costs supplies, and travel costs

3. N/A 3. Estimate expenditures that may arise 3. Estimate expenditures that may arise 3. N/A from unexpected epidemiologic from unexpected epidemiologic activities, such as rapid investigations activities, such as rapid investigations and emergency response and emergency response

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VI. Skill Domain—Financial and Operational Planning and Management (Operational Planning, Financial Planning, and Management Skills)

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert C. Implement operational and financial C. Implement operational and financial C. Oversee implementation of C. Implement operational and financial plans plans operational and financial plans plans for assigned projects

1. N/A 1. Assign tasks to staff members 1. Assign tasks to staff members 1. N/A

2. Compare progress to expectations 2. Compare progress to expectations 2. Compare progress to expectations 2. Compare progress to expectations established in plan established in plan established in plan established in plan

3. N/A 3. Track fiscal expenditures against 3. Evaluate fiscal expenditures against 3. Evaluate fiscal expenditures against financial plan financial plan financial plan

4. Adjust activities as necessary to stay 4. Adjust activities as necessary to stay 4. Adjust activities as necessary to stay 4. Adjust activities as necessary to stay within defined budget within defined budget within defined budget within defined budget

5. Seek additional resources as necessary 5. Seek additional resources as necessary 5. Seek additional resources as necessary 5. N/A to support unexpected activities to support unexpected activities to support unexpected activities

6. Follow chain of command 6. Follow chain of command 6. Follow chain of command and agency 6. Follow chain of command financial rules

D. N/A D. Assist in preparation of proposals for D. Develop requests for proposals for D. Prepare proposals for extramural extramural funding extramural funding to support funding for review and input from additional epidemiologic activities managers and special projects

1. N/A 1. Identify funding needs for 1. Identify epidemiologic activities that 1. Identify funding needs for epidemiologic activities need extramural funding epidemiologic activities

2. N/A 2. Identify funding opportunities for 2. Evaluate funding opportunities to 2. Identify funding opportunities for epidemiologic activities support epidemiologic activities epidemiologic activities

3. N/A 3. Prepare proposals, in whole or in part, 3. Create scientifically sound proposals 3. Prepare proposals, in whole or in part, to obtain funding for epidemiologic that will support epidemiologic to obtain funding for epidemiologic activities activities and meet the requirements of activities the funding agency

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VI. Skill Domain—Financial and Operational Planning and Management (Operational Planning, Financial Planning, and Management Skills)

1. N/A 1. Establish roles and responsibilities of all 1. Establish roles and responsibilities of all 1. N/A participants in epidemiologic activities participants in epidemiologic activities

2. N/A 2. Communicate role/responsibility 2. Communicate role/responsibility 2. N/A expectations clearly to all team expectations clearly to all staff members

3. N/A 3. Assess performance of team members 3. Assess performance of team members 3. N/A as they carry out their responsibilities as they carry out their responsibilities

4. N/A 4. Coach team members as needed in the 4. Coach team members as needed in the 4. N/A performance of their responsibilities performance of their responsibilities

5. N/A 5. N/A 5. Represent epidemiology program on the 5. N/A public health agency management team

F. Use skills that foster collaborations, F. Use skills that foster collaborations, F. Promote collaborations, strong F. Use skills that foster collaborations, strong partnerships, and team strong partnerships, and team partnerships, and team building to strong partnerships, and team building to accomplish epidemiology building to accomplish epidemiology accomplish epidemiology program building to accomplish epidemiology program objectives program objectives objectives program objectives

1. Support collaborative relationships with 1. Build collaborative relationships with 1. Ensure development of collaborative 1. Build collaborative relationships with key personnel of other agencies relevant key personnel of other agencies relevant relationships with key personnel of key personnel of other agencies relevant to the particular epidemiologic activity to the particular epidemiologic activity other programs and agencies relevant to to the particular epidemiologic activity the particular epidemiologic activity

2. Work well with other epidemiology 2. Work well with other epidemiology 2. Lead epidemiology project team 2. Work well with other epidemiology project team members of varied project team members of varied members of varied backgrounds and project team members of varied backgrounds and education backgrounds and education education in working collaboratively backgrounds and education and effectively together

3. N/A 3. Clarify roles and responsibilities of all 3. Oversee development of clear roles and 3. Clarify roles and responsibilities of all participants in epidemiologic activities responsibilities of all participants in participants in epidemiologic activities epidemiologic activities

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VII. Skill Domain—Leadership and Systems Thinking

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert A. N/A A. Support the epidemiologic A. Promote the epidemiologic A. Promote the epidemiologic perspective in the agency strategic perspective in the agency strategic perspective in the agency strategic planning process planning process planning process

B. Support the organization’s vision in B. Promote the organization’s vision in B. Lead the creation of epidemiology B. Promote the organization’s vision in all programs and activities all programs and activities program’s vision in the context of all programs and activities the agency’s plan

1. Support strategic plan 1. Assist in strategic planning 1. Develop strategic plan 1. Assist in strategic planning

a. N/A a. Describe process for organizational a. Develop process for epidemiologic a. Describe process for organizational b. N/A strategic planning strategic planning within agency strategic planning c. N/A b. Identify internal and external issues vision b. Identify internal and external issues d. N/A that may impact delivery of essential b. Evaluate internal and external issues that may impact delivery of essential e. N/A public health services (competency that may impact delivery of essential public health services (competency from Council on Linkages) public health services from Council on Linkages) c. Facilitate collaboration with internal c. Direct collaboration with internal c. Facilitate collaboration with internal and external groups to ensure and external groups to ensure and external groups to ensure participation of key stakeholders participation of key stakeholders participation of key stakeholders (competency from Council on d. Develop strategic priorities and (competency from Council on Linkages) associated action plans Linkages) d. Participate in the development of e. Ensure that research agenda is d. Participate in the development of strategic priorities and associated consistent with budget resources and strategic priorities and associated action plans with strategic plan action plans e. N/A e. Create research agenda for program areas of responsibility for incorporation into strategic plan

2. Support change 2. Implement change 2. Implement change 2. Implement change

a. Demonstrate individual skills a. Demonstrate individual skills a. Demonstrate individual skills a. Demonstrate individual skills necessary to implement change, necessary to implement change, necessary to implement change, necessary to implement change, including ability to support change including ability to support change including ability to support change including ability to support change b. Demonstrate ability to function as b. Demonstrate ability to function as b. Demonstrate ability to lead teams b. Demonstrate ability to function as member of a team during change member of a team during change during change processes member of a team during change processes processes c. Monitor and sustain organizational processes c. N/A c. Participate in monitoring and change c. Participate in monitoring and sustaining organizational change sustaining organizational change

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VII. Skill Domain—Leadership and Systems Thinking

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert C. Use performance measures to C. Use performance measures to C. Use performance measures to C. Use performance measures to improve epidemiology program evaluate and improve epidemiology evaluate and improve epidemiology evaluate and improve epidemiology effectiveness program effectiveness program effectiveness program effectiveness

1. Contribute to implementation and 1. Contribute to development, 1. Develop, implement, and monitor 1. Contribute to development, monitoring of organizational implementation, and monitoring of organizational performance measures implementation, and monitoring of performance measures that demonstrate organizational performance measures that demonstrate program effectiveness organizational performance measures program effectiveness that demonstrate program effectiveness that demonstrate program effectiveness

a. Demonstrate knowledge of a. Demonstrate knowledge of a. Systematize existing organizational a. Demonstrate knowledge of performance measures performance measures performance measures performance measures b. N/A b. Lead process to develop new b. Lead process to develop new b. N/A c. N/A performance measures if necessary performance measures if necessary c. Assist in creating plan for d. Adopt and implement performance c. Assist in creating plan for c. Create plan for implementing implementing performance measures measures implementing performance measures performance measures d. Adopt and implement performance e. N/A d. Adopt and implement performance d. Lead team in implementing measures f. Take action to improve program measures performance measures e. N/A performance e. Evaluate results of performance e. Evaluate results of performance f. Take action to improve program measures’ implementation measures’ implementation performance f. Take action to improve program f. Take action to improve program performance performance

D. Promote ethical conduct in D. Promote ethical conduct in D. Promote ethical conduct in D. Promote ethical conduct in epidemiologic practice epidemiologic practice epidemiologic practice epidemiologic practice

1. Demonstrate ethical conduct in personal 1. Demonstrate ethical conduct in personal 1. Demonstrate ethical conduct in personal 1. Demonstrate ethical conduct in personal behavior and epidemiologic practice behavior and epidemiologic practice behavior and epidemiologic practice behavior

2. Promote ethical conduct in 2. Promote ethical conduct in 2. Promote ethical conduct in 2. Promote ethical conduct in organization’s policies and practices, organization’s policies and practices, organization’s policies and practices, organization’s policies and practices, including emphasis on addressing including emphasis on addressing including emphasis on addressing including emphasis on addressing health disparities health disparities health disparities health disparities

3. N/A 3. Make expectations of ethical conduct 3. Make expectations of ethical conduct 3. Make expectations of ethical conduct clear to team members clear to team members clear to team members

4. Follow organization’s policies and 4. Follow organization’s policies and 4. Enforce organization’s policies and 4. N/A practices related to ethical conduct practices related to ethical conduct practices related to ethical conduct

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VII. Skill Domain—Leadership and Systems Thinking

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert E. Practice professional development E. Promote workforce development E. Ensure professional development of E. Promote workforce development epidemiology workforce

1. N/A 1. Organize team with skills necessary to 1. Assemble teams with necessary skills to 1. Organize team with skills necessary to conduct high-level epidemiologic conduct a range of epidemiologic conduct high-level epidemiologic analyses functions analyses

a. N/A a. Assess skills and abilities needed to a. Assess skills and abilities needed to a. Assess skills and abilities needed to b. N/A perform high-level epidemiologic perform high-level epidemiologic perform high-level epidemiologic c. N/A analyses analyses analyses d. N/A b. Evaluate current agency staff to b. Evaluate current agency staff to b. Evaluate current agency staff to e. N/A determine whether individuals with determine whether individuals with determine whether individuals with f. N/A needed skills and abilities are present needed skills and abilities are present needed skills and abilities are present g. N/A c. N/A c. Assess workforce, workplace, and c. N/A h. N/A d. N/A other issues that impact recruitment d. N/A e. Coordinate with agency management d. Develop recruitment plans that e. Coordinate with agency management to recruit individuals with needed address identified issues to recruit individuals with needed skills if necessary e. Coordinate with agency management skills if necessary f. Collaborate with external to recruit individuals with needed f. Collaborate with external organizations to obtain assistance skills if necessary organizations to obtain assistance with needed analytical support if f. Collaborate with external with needed analytical support if necessary organizations to obtain assistance necessary g. Ensure that teams with necessary with needed analytical support if g. N/A skills to conduct a range of necessary h. Provide coaching to staff performing epidemiologic functions are g. Ensure that teams with necessary epidemiologic analyses incorporated into work plans and the skills to conduct a range of workforce epidemiologic functions are h. Provide coaching to staff performing incorporated into work plans and the epidemiologic analyses workforce h. Provide coaching to staff performing epidemiologic analyses

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VII. Skill Domain—Leadership and Systems Thinking

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert 2. Participate in ongoing team learning 2. Promote ongoing team learning 2. Enable ongoing team learning 2. Promote ongoing team learning

a. N/A a. Assess the proficiency of team a. Assess the proficiency of team a. Assess the proficiency of team b. N/A members’ skills against standard members’ skills against standard members’ skills against standard c. N/A competency sets competency sets competency sets d. N/A b. Identify professional development b. Identify professional development b. Identify professional development e. Assess personal educational and opportunities for team members opportunities for team members opportunities for team members training needs, and seek additional c. Adjust workload of team members as c. Adjust workload of team members as c. N/A education and training as necessary necessary to enable participation in necessary to enable participation in d. Encourage team members to take professional development professional development advantage of development opportunities opportunities opportunities d. Encourage team members to take d. Provide resources for team members e. Assess personal educational and advantage of development to take advantage of development training needs, and seek additional opportunities opportunities education and training as necessary e. Assess personal educational and e. Assess personal educational and training needs, and seek additional training needs, and seek additional education and training as necessary education and training as necessary

3. N/A 3. Retain epidemiology staff 3. Retain epidemiology staff 3. N/A

a. N/A a. Assess issues affecting workforce a. Assess issues affecting workforce a. N/A b. N/A retention retention b. N/A c. N/A b. Evaluate strategies to improve b. Evaluate strategies to improve c. N/A workforce retention workforce retention c. Develop strategies to retain staff c. Develop strategies to retain staff consistent with agency human consistent with agency human resource retention strategies resource retention strategies

F. Prepare for emergency response F. Prepare for emergency response F. Lead epidemiology unit in preparing F. Prepare for emergency response for emergency response

1. N/A 1. Present epidemiologic perspective in 1. Present epidemiologic perspective in 1. N/A development of agency emergency development of agency emergency response plan response plan

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VII. Skill Domain—Leadership and Systems Thinking

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert 2. N/A 2. Participate in emergency response 2. Lead emergency response planning for 2. Participate in emergency response planning for epidemiology unit epidemiology unit planning for epidemiology unit

a. Be familiar with the epidemiology a. Participate in the development of a a. Ensure that the agency (or agency a. Participate in the development of a section of emergency response plan written epidemiology section in the unit) has a written epidemiology written epidemiology section in the b. N/A agency’s or agency unit’s emergency section in the agency’s or agency agency’s or agency unit’s emergency c. N/A response plan, including continuity unit’s emergency response plan, response plan, including continuity d. Participate in regular exercises of agency operations including continuity of agency of agency operations and/or drills of all parts of b. Communicate epidemiologic operations b. Communicate epidemiologic emergency response information, roles, capacities, and b. Ensure communication of epi- information, roles, capacities, and e. N/A legal authority to all emergency demiologic information, roles, legal authority to all emergency f. Obtain necessary continuing response partners capacities, and legal authority to all response partners education to respond to emergencies c. Maintain regular communication emergency response partners c. Maintain regular communication with emergency response partners c. Ensure regular communication with with emergency response partners d. Participate in regular exercises emergency response partners d. Participate in regular exercises and/or drills of all parts of d. Lead epidemiology unit’s and/or drills of all parts of emergency response participation in regular exercises emergency response e. Participate in the evaluation of and/or drills of all parts of e. Participate in the evaluation of emergency response exercises and/or emergency response emergency response exercises and/or drills (or actual response) e. Evaluate the participation of the drills (or actual response) f. Ensure that staff receive necessary epidemiology unit in emergency f. Obtain necessary continuing continuing education to respond to response exercises and/or drills (or education to respond to emergencies emergencies actual response) f. Ensure that staff receive necessary continuing education to respond to emergencies

3. Respond to public health emergencies 3. Respond to public health emergencies 3. Lead epidemiologic response to public 3. Respond to public health emergencies health emergencies

a. Adhere to individual’s role in a. Adhere to individual’s role in a. Ensure that epidemiology staff a. Adhere to individual’s role in incident command and incident incident command and incident adhere to their roles in incident incident command and incident management management command and incident management management b. Maintain regular communication b. Maintain regular communication b. Ensure that regular communication is b. Maintain regular communication with partner professionals in other with partner professionals in other maintained with partner with partner professionals in other agencies involved in emergency agencies involved in emergency professionals in other agencies agencies involved in emergency response response involved in emergency response response

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VIII. Skill Domain—Policy Development

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert A. Support the application of A. Bring epidemiologic perspective in A. Bring epidemiologic perspective in A. Bring epidemiologic perspective in epidemiologic knowledge to the the development and analysis of the development and analysis of the development and analysis of development and analysis of public public health policies public health policies public health policies health policies

1. Describe how policy decisions are made 1. Demonstrate understanding of public 1. Evaluate public health policies and 1. Demonstrate understanding of public within the agency health policies and policy development policy development from an health policies and policy development from an epidemiologic perspective epidemiologic perspective from an epidemiologic perspective

a. N/A a. Describe breadth and limitations of a. Examine breadth and limitations of a. Describe breadth and limitations of b. N/A existing regulations and laws at existing regulations and laws at existing regulations and laws at c. Provide epidemiologic and evidence- agency, local, state, and federal agency, local, state, and federal agency, local, state, and federal based information and data in the levels that affect epidemiologic levels that affect epidemiologic levels that affect epidemiologic development of new policies, activities activities activities including data that demonstrate the b. Demonstrate to decision-makers the b. Justify the use of epidemiology and b. Demonstrate to decision-makers the need for change in existing policies value of epidemiology and other other evidence-based information in value of epidemiology and other d. Assist in creating decision memos evidence-based information in developing policy evidence-based information in that outline policy alternatives and developing policy c. Synthesize epidemiologic and developing policy facilitate scientifically sound c. Provide epidemiologic and evidence- evidence-based information and data c. Provide epidemiologic and evidence- decision-making based information and data in the for presentation to policy makers based information and data in the development of new policies, d. Create decision memos that outline development of new policies, including data that demonstrate the policy alternatives and facilitate including data that demonstrate the need for change in existing policies scientifically sound decision-making need for change in existing policies d. Participate in creating decision d. Participate in creating decision memos that outline policy memos that outline policy alternatives and facilitate alternatives and facilitate scientifically sound decision-making scientifically sound decision-making

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VIII. Skill Domain—Policy Development

Tier 3a: Senior-Level Epidemiologist: Tier 3b: Senior Scientist/ Tier 1: Entry-Level or Basic Epidemiologist Tier 2: Mid-Level Epidemiologist Supervisor and/or Manager Subject Area Expert 2. N/A 2. Support development of policies 2. Lead development of policies relating to 2. Support development of policies relating to epidemiologic activities epidemiologic activities relating to epidemiologic activities

a. N/A a. Provide input into the development a. Create opportunities for staff to a. Provide input into the development b. N/A of new policies provide input into the development of new policies c. N/A b. N/A of new policies b. N/A d. N/A c. Advise in the development of draft b. Incorporate public input into c. Advise in the development of draft e. N/A policy language to support necessary development of epidemiologic policy language to support necessary epidemiologic actions and activities policies epidemiologic actions and activities d. N/A c. Create draft policy language to d. N/A e. Examine the impact of policies on support necessary epidemiologic e. Examine the impact of policies on achieving epidemiology program actions and activities achieving epidemiology program goals and objectives d. Follow agency procedures for goals and objectives adopting and implementing new policies e. Evaluate the impact of policies on achieving epidemiology program goals and objectives

3. Support epidemiology roles in programs 3. Participate in translation of public 3. Translate public health policies into 3. Participate in translation of public or plans that derive from public health health policies into epidemiology roles epidemiology roles in programs or plans health policies into epidemiology roles policies in programs or plans in programs or plans

4. N/A 4. Demonstrate ability to use designated 4. Use designated channels to influence 4. Demonstrate ability to use designated channels to influence policy decisions policy decisions made by entities other channels to influence policy decisions made by entities other than the public than the public health agency (e.g., made by entities other than the public health agency (e.g., elected officials or elected officials or their staffs) health agency (e.g., elected officials or their staffs) their staffs)

5. Adhere to rules and laws applying to 5. Adhere to rules and laws applying to 5. Adhere to rules and laws applying to 5. Adhere to rules and laws applying to government employees and funding government employees and funding government employees and funding government employees and funding sources regarding lobbying sources regarding lobbying sources regarding lobbying sources regarding lobbying

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